Fitness Files: Online medical care is convenient but tricky

My son, daughter and their spouses communicate with me by text. Terse messages with postage stamp-sized photos of grandchildren or vacation videos.

I’ve adjusted. I no longer expect the cellphone’s ding-a-ling to signal a warm human voice, but instead words, photos and, worst of all, what I call “immodiums,� otherwise known as emoticons.

So my reaction was luke warm when my editor forwarded information about a new form of medicine: online urgent care.

I interviewed Jackie Amster, vice president of marketing for Laguna Dana Urgent Care’s six walk-in clinics in Orange County and SmartExam virtual visits.

Using SmartExam, sick patients go online to fill in a questionnaire describing their illnesses. A doctor reads the symptoms and sends a prescription to the pharmacy. Consultations, available 8 a.m. to 4:30 p.m. Monday through Friday, cost $50 cash, no insurance accepted.

Amster tells me that Laguna Dana Urgent Care identified the most common causes of urgent care visits and developed algorithms to help pinpoint problems. If the patient’s symptoms do not fit in the algorithm, the virtual consultation is discontinued and he or she’s not charged.

The day after the online appointment, medical staff makes a follow-up call.

Urgent Care’s most common visits involve a cough or a cold; allergies; a hoarse voice or sore throat; chest Infection; flu; sinus pain; urinary tract infection; ear ache; a burn or sunburn; and pink eye or a sty.

In searching for articles that discuss the pros and cons of such online doctoring, I find none. I do find site after site of advertisements for the service. I do not claim to be a professional researcher, but as far as my Googling goes, it seems that online urgent care is proliferating without investigation of its efficacy.

Amster said she doesn’t think there are any negatives, but guessed that I was unable to find much written about the subject because virtual doctor visits “are only about two years old.�

Next, I asked a friend, a general practitioner, about online diagnoses.

“I’ll give you an example of possible limitations,� he said. “A sore throat looks different if tonsils cause the pain versus strep.� He also demonstrated how he feels for swelling of lymph glands. “Treatments vary according to examination,� he said.

I told him that practicing medicine by a quick diagnosis of a single symptom and a rapid reach for the prescription pad bothers me. I imagine what’s lost is the doctor’s review of patient’s history and ability to look at the person as a whole.

My friend, the doctor answered, “There are patients who come in saying, ‘Give me a pill to get well.’ That’s whom online’s for.�

I called Amster again. This time she gave me a new name for online medicine, “telemedicine.� Using this search word, I found a news release by the Rand Corp., “First Assessment of National Telemedicine Finds it Appears to Expand Access to Acute Medical Care.�

“Younger, more affluent� people tend to use it, but “little is known about how these services are being used, and whether they provide good quality care.� And “some providers fear the limitations …can lead to misdiagnosis.�

Just got a text from my daughter. “Jason is on board for OC Fair tomorrow [smiley face].� She and Jason sprint between jobs, kids and social obligations, glancing at their phones often. They’d whip out an online medical questionnaire and take their pills on the way to wherever they were headed.

I’m going to call my daughter. Planning a trip to the fair is too complicated for texting. Maybe medicine’s too complicated for computer communication too.

Newport Beach resident CARRIE LUGER SLAYBACK is a retired teacher who ran the Los Angeles Marathon at age 70, winning first place in her age group. Her blog is [email protected].